Localized projection of audible noises in medical settings

ABSTRACT

A localized sound projection system can coordinate the sounds of speakers to simulate the placement of an auditory cue in a 3D space. The system can include a plurality of speakers configured to output auditory signals and a sound localization controller configured to control the plurality of speakers to coordinate the auditory signals to simulate an origination location of a patient alarm. The sound localization controller can determine adjusted auditory signals and control a plurality of speakers to output the plurality of adjusted auditory signals. A method for dynamically controlling speaker settings in a medical environment can include determining volume settings corresponding to a speaker, monitoring a level of ambient noise corresponding to a room of a patient, controlling the volume settings of the speaker to reduce or increase a sound level output of a speaker. A patient monitoring system can be configured to physically manipulate medical devices in response to audible commands. The system can receive a plurality of vocal commands from a user and can manipulate various settings after confirmation from a user.

RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.15/905,332, filed Feb. 26, 2018, entitled “Localized Projection OfAudible Noises In Medical Settings,” which claims the benefit of U.S.Provisional Application No. 62/463,490, filed Feb. 24, 2017, entitled“Medical Monitoring Hub,” each of which is incorporated by reference inits entirety.

TECHNICAL FIELD

The present disclosure relates generally to improvements in patientmonitoring devices.

BACKGROUND

Today's patient monitoring environments are crowded with sophisticatedand often electronic medical devices servicing a wide variety ofmonitoring and treatment endeavors for a given patient. Generally, manyif not all of the devices are from differing manufactures, and many maybe portable devices. The devices may not communicate with one anotherand each may include its own control, display, alarms, configurationsand the like.

The result of such device disparity is often a caregiver environmentscattered with multiple displays and alarms leading to a potentiallychaotic experience. Such chaos can be detrimental to the patient in manysituations including surgical environments where caregiver distractionis unwanted, and including recovery or monitoring environments wherepatient distraction or disturbance may be unwanted.

SUMMARY

The present disclosure provides for improved monitoring of patientsthrough the use of localized projection of audible noises to direct acare provider quickly and intuitively to a particular direction orlocation. The system can include a plurality of speakers configured tooutput auditory signals, and a sound localization controller. The soundlocalization controller can be in communication with the speakers andcan be configured to control the speakers to coordinate the auditorysignals to simulate an origination location. The sound localizationcontroller can include a processor that can be configured to receive anindication of an activation of the patient indicator and determine theorigination location of the patient indicator based at least in part onthe indication of the activation of the patient indicator. Based atleast in part on the origination location and a location of each of aplurality of speakers, the processor can identify sound parameters foreach of the plurality of speakers. The sound parameters can correspondto at least one of a timing, intensity, or frequency of a sound signal.The processor can determine adjusted auditory signals based at least inpart on the identified sound parameters, and can control the pluralityof speakers to output the plurality of adjusted auditory signals.

The system of the preceding paragraph may also include any combinationof the following features described in this paragraph, among othersdescribed herein. The system can further include a patient monitoringdevice configured to receive one or more patient signals from one ormore physiological sensors, determine measurements of physiologicalparameters of a patient from the received one or more patient signals,monitor patient indicator criteria associated with the one or moremeasurements of the one or more physiological parameters, and transmitthe indication of the activation of the patient indicator. Theorigination location can include at least one of a location of aphysiological sensor, a patient monitoring device, a patient, a patientroom, or one of the plurality of speakers. The adjusted auditory signalscan include at least one alarm signal and at least one time-delay alarmsignal.

The system of any of the preceding paragraphs may also include anycombination of the following features described in this paragraph, amongothers described herein. The plurality of speakers can include a firstspeaker and a second speaker. The first speaker can be configured tooutput the at least one audible noise, such as an alarm signal, and thesecond speaker can be configured to output the at least one time-delayedaudible noise. The at least one time-delayed alarm signal can be atime-delayed copy of the alarm signal. The at least one time-delayedalarm signal can be time-delayed from the alarm signal by a fewmilliseconds. The plurality of speakers can be located in a patientroom. The first speaker can be located closer to the originationlocation than the second speaker is. The alarm signal can include aheartbeat signal corresponding to a patient's heartbeat.

The present disclosure also provides for an improved monitoring devicefor adjusting auditory settings based on acoustics of the environment.The patient monitoring device includes a plurality of speakersconfigured to output auditory signals, a noise sensor, and an acousticscontroller having a processor. The processor can be configured tocontrol the plurality of speakers to output one or more test auditorysignals, receive noise data from the noise sensor corresponding to theone or more test auditory signals, determine acoustics of a surroundingenvironment based at least in part on the received noise data, andadjust one or more speaker parameters of the plurality of speakers basedon the determined acoustics.

The device of the preceding paragraph may also include any combinationof the following features described in this paragraph, among othersdescribed herein. The plurality of speakers can include a first speakerand a second speaker. The adjustment of the one or more speakerparameters can optimize the output auditory signals for the determinedacoustics of the surrounding environment.

A system is configured to connect to a plurality of devices, each devicehaving one or more speakers. The system can transmit a request to eachof the plurality of devices. The request can request that each of thedevices provide a test sound through the respective speakers. The systemcan listen for the test sound of the speakers and can determine at leastone of a location, distance, and volume of each of the speakers. Thepatient monitoring system can use at least one of the plurality ofspeakers to provide a one or more audible noises. In some cases, thesystem communicates with each of the devices in sequence. In some cases,the system communicates with each of the devices simultaneously.

The present disclosure also provides for dynamically controlling speakersettings in a medical environment. This can include determining, using anoise sensor, volume settings corresponding to a speaker of anelectrical device. Dynamically controlling speaker settings can furtherinclude monitoring, using a noise sensor, a level of ambient noisecorresponding to a room of a patient, and controlling the volumesettings of the speaker to adjust a sound level output of a speakerbased at least in part on a determination that one or more volumeadjustment conditions are satisfied.

The dynamically controlling speaker settings of the preceding paragraphmay also include any combination of the following features or stepsdescribed in this paragraph, among others described herein. The one ormore volume adjustment conditions can include determining, based on thelevel of ambient noise, that the patient, the room of the patient, orthe speaker is located in a quiet zone of a hospital, and determining,based at least in part on a time of day, that quiet hours are ongoing.The dynamically controlling speaker settings can further includeadjusting the sound level output of the speaker to reduce the soundlevel output of the speaker.

The dynamically controlling speaker settings of any of the preceding twoparagraphs may also include any combination of the following features orsteps described in this paragraph, among others described herein. Theone or more volume adjustment conditions can include determining, basedon the level of ambient noise, that the patient, the room of thepatient, or the speaker is not located in a quiet zone of a hospital,and determining, based at least in part on a time of day, that quiethours are not ongoing. The dynamically controlling speaker settings canfurther include adjusting the sound level output of the speaker toincrease the sound level output of the speaker.

The dynamically controlling speaker settings of any of the precedingthree paragraphs may also include any combination of the followingfeatures or steps described in this paragraph, among others describedherein. The noise sensor can include at least one of a decibel reader ora microphone. The level of ambient noise can correspond to the level ofambient noise in a room of a patient. The method can further includeadjusting the volume settings of the speaker by a predetermined amount.The method can further include adjusting the volume settings of thespeaker to a predetermined volume setting.

The present disclosure also provides for dynamically controlling displaysettings in a medical environment. This can include determining displaysettings corresponding to a display. Dynamically controlling displaysettings can further include monitoring, using an ambient light sensor,a level of ambient light corresponding to a surrounding environment, andadjusting the display settings of the display based on a displaysettings threshold.

The dynamically controlling display settings of the preceding paragraphmay also include any combination of the following features or stepsdescribed in this paragraph, among others described herein. Dynamicallycontrolling display settings can further include determining the displaysettings threshold based on the level of ambient light, and adjustingthe display settings based at least in part on a comparison of thedisplay settings to a display settings threshold.

In some aspects of the present disclosure, a method of audibly alteringparameters of a medical device can include receiving, using amicrophone, a first vocal command, and interpreting the first vocalcommand as an activation phrase configured to initiate a process ofaudibly altering parameters of a medical device. The method can furtherinclude controlling a speaker to provide an audible indication of anacknowledgment of the activation phrase and initiation of the process ofaudibly altering parameters of the medical device. The method canfurther include, after controlling the speaker to provide the audibleindication, receiving, using the microphone, a second vocal command. Themethod can further include interpreting the second vocal command as arequest to alter the parameters of the medical device, and causing adisplay to display, in text, an indication of the interpreted request toalter the parameters. The indication can include a request forconfirmation. The method can further include receiving the confirmationand altering the parameters of the medical device.

The method of the preceding paragraph may also include any combinationof the following features or steps described in this paragraph, amongothers described herein. The method can further include receiving athird vocal command, failing to interpret the third vocal command, andcontrolling the speaker to provide an audible indication that the thirdvocal command was not interpreted. The confirmation can be receivedusing the microphone. The confirmation can be received using an inputdevice. The input device can include a touch screen or keyboard.

A patient monitoring system can include a speaker. The speaker caninclude a large speaker chamber. Based on the size of the speakerchamber, the speaker can produce a low-frequency sound that can travelfurther than convention patient monitoring speakers produce, withouthaving a higher volume. The low-frequency speaker can be configured topass through walls or doors to alert care providers outside of a room toan activation of the patient indicator.

For purposes of summarizing the disclosure, certain aspects, advantagesand novel features are discussed herein. It is to be understood that notnecessarily all such aspects, advantages or features will be embodied inany particular embodiment of the invention and an artisan wouldrecognize from the disclosure herein a myriad of combinations of suchaspects, advantages or features.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings and the associated descriptions are provided toillustrate embodiments of the present disclosure and do not limit thescope of the claims.

FIG. 1 is an example block diagram of a patient monitoring device.

FIG. 2A is a perspective view of an example patient monitoring deviceincluding a hub and the patient monitoring device of FIG. 1.

FIG. 2B illustrates an example hardware block diagram of the hub of FIG.2B.

FIG. 3 illustrates a perspective view of a back side of the patientmonitoring device of FIG. 2A.

FIG. 4 is illustrates an example speaker for producing an audible noise.

FIGS. 5A-5C illustrate example localized sound projection systems forproviding localized projection of audible noises.

FIG. 6 is a flow diagram illustrative of an embodiment of a routineimplemented by a system to provide localized projection of audiblenoises via a plurality of speakers.

FIG. 7 is a flow diagram illustrative of an embodiment of a routineimplemented by a system to adjust speaker settings based on surroundingacoustics.

FIG. 8 illustrates a flow diagram of an example routine for adjustingvolume of a speaker.

FIG. 9 is a flow diagram illustrative of an example routine foradjusting display settings of a display.

FIG. 10 is a flow diagram illustrative of an example routine for audiblyaltering parameters of a medical device.

While the foregoing “Brief Description of the Drawings” referencesgenerally various embodiments of the disclosure, an artisan willrecognize from the disclosure herein that such embodiments are notmutually exclusive. Rather, the artisan would recognize a myriad ofcombinations of some or all of such embodiments.

DETAILED DESCRIPTION

FIG. 1 is an example block diagram of a patient monitoring device. Thepatient monitoring device can include a docked portable patient monitor100, which may be referred to herein as the patient monitoring device100. The patient monitoring device 100 may advantageously include anoximeter, co-oximeter, respiratory monitor, depth of sedation monitor,noninvasive blood pressure monitor, vital signs monitor or the like,such as those commercially available from Masimo Corporation of Irvine,Calif., and/or disclosed in U.S. Patent Publication Nos. 2002/0140675,2010/0274099, 2011/0213273, 2012/0226117, 2010/0030040; U.S. PatentApplication Ser. Nos. 61/242,792, 61/387,457, 61/645,570, 13/554,908 andU.S. Pat. Nos. 6,157,850, 6,334,065, and the like.

The patient monitoring device 100 can include a first processor 104, adisplay, 106, and an OEM board 108. The patient monitoring device 100further includes one or more cables 110 and an antenna 112 for wired andwireless communication, respectively.

The OEM board 108 can include an instrument board 114, a core ortechnical board 116, and memory 118. In some cases, the memory 118 caninclude a user interface module 120, a signal processing module 122,instrument configuration parameters 124, and local configurationparameters 126.

The patient monitoring device 100 may communicate with a variety ofnoninvasive and/or minimally invasive sensors 102 such as opticalsensors with light emission and detection circuitry, acoustic sensors,devices that measure blood parameters from a finger prick, cuffs,ventilators, ECG sensors, pulse oximeters, and the like.

One or more of the sensors 102 can be attached to a medical patient. Thesensors 102 can obtain physiological information from a medical patientand transmit this information to the technical board 116 through cables130 or through a wireless connection (not shown). The physiologicalinformation can include one or more physiological parameters or valuesand waveforms corresponding to the physiological parameters.

The technical board 116 can receive physiological information from thesensors 102. The technical board 116 can include a circuit having asecond processor, which may be the same as the first processor 104, andinput ports for receiving the physiological information. The technicalboard 116 can access the signal processing module 122 to process thephysiological information in the second processor. In addition, thetechnical board 116 can include one or more output ports, such as serialports. For example, an RS232, RS423, or autobaud RS232 (serial interfacestandard) port or a universal serial bus (USB) port may be included inthe technical board 116.

The technical board 116 and the signal processing module 122 can includea sensor processing system for the patient monitoring device 100. Insome cases, the sensor processing system generates waveforms fromsignals received from the sensors 102. The sensor processing system mayalso analyze single or multiparameter trends to provide early warningalerts to clinicians prior to an alarm event. In addition, the sensorprocessing system can generate alarms in response to physiologicalparameters exceeding certain safe thresholds.

Example alerts include no communication with the patient monitoringdevice 100, alarm silenced on the patient monitoring device 100,instrument low battery (patient monitoring device 100), and transmitterlow battery. Example physiological parameters include SpO₂ levels, highand low SpO₂, high and low PR, HbCO level, HbMET level, pulse rate,perfusion index, signal quality, HbCO, HbMET, PI, and desat index.Additional example alarms include SpO₂ alarms, high and low SpO₂ alarms,high and low PR, HbCO alarms, HbMET alarms, pulse rate alarms, no sensoralarms, sensor off patient alarms, sensor error, low perfusion indexalarm, low signal quality alarm, HbCO alarm, HbMET alarm, PI trendalarm, and desat index alarm.

The instrument board 114 can receive the waveforms, alerts, alarms, andthe like from the technical board 116. The instrument board 114 caninclude a circuit having a third processor, which may be the same as thefirst processor 104, and input ports for receiving the waveforms,alerts, and alarms from the technical board 116 and output ports forinterfacing with the display 106, a speaker or other device capable ofproducing an audible indication. The instrument board 114 can access theuser interface module 120 to process the waveforms, alerts, and alarmsto provide indications of the waveforms, alerts, alarms or other dataassociated with the physiological parameters monitored by the sensors102. The indications can be displayed on the display 106. In addition oralternatively, the alerts and alarms are audible. The indications,alerts, and alarms can be communicated to end-user devices, for example,through a hospital backbone, a hospital WLAN 16, and/or the Internet.

Additionally, the instrument board 114 and/or the technical board 116may advantageously include one or more processors and controllers,busses, all manner of communication connectivity and electronics,memory, memory readers including EPROM readers, and other electronicsrecognizable to an artisan from the disclosure herein. Each board caninclude substrates for positioning and support, interconnect forcommunications, electronic components including controllers, logicdevices, hardware/software combinations and the like to accomplish thetasks designated above and others.

An artisan will recognize from the disclosure herein that the instrumentboard 114 and/or the technical board 116 may include a large number ofelectronic components organized in a large number of ways.

Because of the versatility needed to process many differentphysiological parameters, the technical board 116 can further include arevision number or other indication of the circuit design andcapabilities of a specific technical board 116.

Likewise, because of the versatility needed to display the processedphysiological parameters for use by many different end users, theinstrument board 114 can further include a revision number or otherindication of the circuit design and capabilities of the specificinstrument board.

Software is also subject to upgrading to increase its capabilities. Thesignal processing module 122 can further include a version number orother indication of the code found in the specific signal processingmodule 122. Likewise, the user interface module 120 can further includea version number or other indication of the code found on the specificuser interface module 120.

Some or all of the serial numbers, the model numbers, and the revisionnumbers of the technical board 116 and the instrument board 114 thatinclude the specific patient monitoring device 100 can be stored in theinstrument configuration parameters 124. Further, the version numbers ofthe signal processing module 122 and the user interface module 120 arestored in the instrument configuration parameters 124. The instrumentconfiguration parameters 124 can further include indications of thephysiological parameters that are enabled, and indications of thephysiological parameters that are capable of being enabled for thepatient monitoring device 100.

The location of the patient monitoring device 100 can affect thesensitivity at which a physiological parameter is monitored. Forexample, a physiological parameter may be monitored with greatersensitivity when the patent monitoring device 100 is located in theneonatal intensive care unit (NICU), OR or surgical ICU than when it islocated in an adult patient's room. In some cases, the location of thepatient monitoring device 100 may affect the availability of the devicefor another patient. For example, a patient monitoring device 100located in the hospital discharge area may be available for anotherpatient, whereas one located in a patient's room may not be availableanytime soon.

The local configuration parameters 126 can include a location of thepatient monitoring device 100 within the facility, an indication ofwhether the device is configured for adult or pediatric monitoring, andthe like.

The sensor 102 can include memory 128. The memory 128 can includeinformation associated with the sensor 102, such as, but not limited toa sensor type, a sensor model number, a sensor revision number, a sensorserial number, and the like.

The patient monitoring device 100 can include a Radical-7® Rainbow SETPulse Oximeter by Masimo Corporation, Irvine, Calif. The OEM board 108can be produced by Masimo Corporation, Irvine, Calif. and used by othersto produce patient monitoring devices.

FIG. 2A illustrates a perspective view of an example patient monitoringdevice, such as a medical monitoring hub with the docked portablepatient monitoring device 100, the combination of which may also bereferred to herein as a patient monitoring device or patient monitoringsystem 200. The hub includes a display 224, and a docking station 226,which can be configured to mechanically and electrically mate with theportable patient monitoring device 100, each housed in a movable,mountable and portable housing 228. The housing 228 includes a generallyupright inclined shape configured to rest on a horizontal flat surface,although the housing 228 can be affixed in a wide variety of positionsand mountings and include a wide variety of shapes and sizes.

The display 224 may present a wide variety of measurement and/ortreatment data in numerical, graphical, waveform, or other displayindicia 232. The display 224 can occupy much of a front face of thehousing 228; although an artisan will appreciate the display 224 mayinclude a tablet or tabletop horizontal configuration, a laptop-likeconfiguration or the like. Other examples may include communicatingdisplay information and data to a table computer, smartphone,television, or any display system recognizable to an artisan. Theupright inclined configuration of FIG. 2A presents display informationto a caregiver in an easily viewable manner. The patient monitoringdevice 200 may display information for a variety of physiologicalparameters, such as but not limited to oxygen saturation (SpO2),hemoglobin (Hb), oxyhemoglobin (HbO2), total hemoglobin,carboxyhemoglobin, methemoglobin, perfusion index (Pi), pulse rate (PR)of blood pressure, temperature, electrocardiogram (ECG), motion data,accelerometer data, respiration, continuous blood pressure, plethvariability index, oxygen content, oxygen reserve index, acousticrespiration rate (RRa), and respiration rate from the pleth.

FIG. 2B illustrates a simplified example hardware block diagram of thepatient monitoring device 200. As shown in FIG. 2B, the housing 228 ofthe patient monitoring device 200 positions and/or encompasses aninstrument board 202, a core or technical board 212, the display 224,memory 204, and the various communication connections, including serialports 230, channel ports 222, Ethernet ports 205, nurse call port 206,other communication ports 208 including standard USB, or the like, and adocking station interface 210. The instrument board 202 can include oneor more substrates including communication interconnects, wiring, portsand the like to enable the communications and functions describedherein, including inter-board communications. The technical board 212includes the main parameter, signal, and other processor(s) and memory.A portable monitor board (“RIB”) 214 includes patient electricalisolation for the monitor 100 and one or more processors. A channelboard (“MID”) 216 controls the communication with the channel ports 222including optional patient electrical isolation and power supply 218,and a radio board 220 includes components configured for wirelesscommunications.

Additionally, the instrument board 202 and/or the technical board 212may advantageously include one or more processors and controllers,busses, all manner of communication connectivity and electronics,memory, memory readers including EPROM readers, and other electronicsrecognizable to an artisan from the disclosure herein. Each board caninclude substrates for positioning and support, interconnect forcommunications, electronic components including controllers, logicdevices, hardware/software combinations and the like to accomplish thetasks designated above and others.

An artisan will recognize from the disclosure herein that the instrumentboard 202 and or the technical board 212 may include a large number ofelectronic components organized in a large number of ways.

Because of the versatility needed to process many differentphysiological parameters, the technical board 212 can further include arevision number or other indication of the circuit design andcapabilities of a specific technical board 212.

Likewise, because of the versatility needed to display the processedphysiological parameters for use by many different end users, theinstrument board 202 can further include a revision number or otherindication of the circuit design and capabilities of the specificinstrument board 202.

The memory 204 can include a user interface module 240, a signalprocessing module 242, instrument configuration parameters 244, andlocal configuration parameters 246.

The instrument board 202 can access the user interface module 240 toprocess the waveforms, alerts, and alarms to provide indications of thewaveforms, alerts, alarms or other data associated with thephysiological parameters for the patient monitoring device 200. Thetechnical board 212 can access the signal processing module 242 toprocess the physiological information for the patient monitoring device200.

Software for the patient monitoring device 200 is also subject toupgrading to increase its capabilities. The signal processing module 242can further include a version number or other indication of the codefound in the specific signal processing module 242. Likewise, the userinterface module 240 can further include a version number or otherindication of the code found on the specific user interface module 240.

Some or all of the serial numbers, the model numbers, and the revisionnumbers of the technical board 212 and the instrument board 202 thatinclude the specific patient medical monitoring hub 150 can be stored inthe instrument configuration parameters 244. Further, the versionnumbers of the signal processing module 242 and the user interfacemodule 240 can be stored in the instrument configuration parameters 244.The instrument configuration parameters 244 further include indicationsof the physiological parameters that are enabled, and indications of thephysiological parameters that are capable of being enabled for thepatient monitoring device 200.

The local configuration parameters 246 can include a location of thepatient monitoring device 200 within the facility, an indication ofwhether the device is configured for adult or pediatric monitoring, andthe like.

The patient monitoring device 200 can include a Root® Patient Monitoringand Connectivity Platform by Masimo Corporation, Irvine, Calif. thatincludes the Radical-7® also by Masimo Corporation, Irvine, Calif.

FIG. 3 illustrates an example perspective view of a back side of thepatient monitoring device 200 of FIG. 2A, showing an example serial datainputs. The inputs can include RJ 45 ports. As is understood in the art,these ports include data ports similar to those found on computers,network routers, switches and hubs. A plurality of these ports can beused to associate data from various devices with the specific patientidentified in the patient monitoring device 200. FIG. 2B also shows aspeaker, the nurse call connector, the Ethernet connector, the USBs, apower connector and a medical grounding lug.

Low-Frequency Speaker

FIG. 4 is illustrates an example speaker 400 that can be incorporatedinto or in communication with a patient monitoring device and canproduce one or more audible noises. Advantageously, the speaker 400 canproduce a sound wave that can travel further and sound differently thanconventional speakers, thereby increasing a likelihood that a caregivercan hear, and ultimately respond to, the audible noise.

As described here, a patient monitoring device can be configured toreceive one or more signals from a physiological sensor, determine oneor more measurements of the one or more physiological parameters of apatient from the received signal, and determine one or more conditionsassociated with the one or more measurements of the one or morephysiological parameters. The patient monitoring device can communicatewith speaker 400 and cause the speaker to produce an audible noise,which can include an alarm or other sound, such as a heat beat, a chirpor any other noise meant to obtain the attention of the care provider inan intuitive way. In some cases, the audible noise can be intended toalert a caregiver of an alarm condition or of the activation of thepatient indicator. Accordingly, it can be of vital importance to thehealth of the patient for a caregiver to hear and respond to the audiblenoise of the speaker 400.

Unfortunately, especially in a hospital environment when nurses anddoctors are responsible for a multitude of patients, it can be difficultto provide an audible noise that can be heard by a caregiver, who mightbe a substantial distance from the patient such as outside of thepatient's room. One solution might be to make the audible noise louder,but this solution comes with its disadvantages, such as causing damageto a nearby patient's hearing or simply disrupting any serenity providedby the hospital. Speaker 400 can advantageously produce a sound wavethat can travel further than conventional speakers can (for example,passing through walls), yet is not louder in volume than conventionalspeakers are. Accordingly, the speaker 400 can increase a likelihoodthat an audible noise will be heard by a caregiver.

In contrast to traditional speakers, the speaker 400 has an increasedsize. For example, any of the, length 410, width 412, height 414, ordiameter 408 can larger than that of a traditional speaker. Furthermore,and the speaker includes a large acoustic chamber that allows thespeaker 400 to produce sound waves that have lower frequencies. Wallsreflect and/or absorb most high and medium frequency sound. Theremaining low frequency energy that is not reflected or absorbed passesthrough the wall. Accordingly, the speaker 400 can produce a lowfrequency that generally passes through walls.

Localized Projection

FIGS. 5A-5B illustrate example localized sound projection systems 500A,500B for providing localized projection of audible noises. The localizedsound projection systems 500A, 500B can coordinate the audible noises ofvarious speakers to simulate the placement of an auditory cue in a threedimensional space. In other words, systems 500A, 500B adjust soundparameters to fool a listener's brain into thinking an audible noiseoriginates from a particular location. This provides the advantage ofintuitively directing a care provider's attention to a location that canaid the care provider in caring for the patient.

As illustrated in FIG. 5A, the localized sound projection system 500Acan be implemented on a floor of a medical facility to aid caregivers ineffectively monitoring their patients. The floor has a generallycircular layout, which advantageously provides a functional flow thatbenefits both the patients and the staff. Patient rooms 506 can belocated around the exterior of the floor and the nurses' stations 504can be centrally located on the floor to minimize a distance between anurse and any particular patient's room 506.

To aid in monitoring the patients, in many cases, the nurses' desks areoriented in a nursing station 504 such that the nurses' backs are toeach other or to a supply room 502 and their faces are directed to thepatients' rooms 506. Each of the nurses at the nurses station can beassigned a set of patients, and, in many circumstances, this assignmentcan be based on the patient room locations on the floor. For example,with four nurses working the floor and two at each nursing station 504,each of the nurses can be assigned a quarter of the floor. Accordingly,a particular nurse is responsible for any patient residing in a patientroom 506 that corresponds to the assigned quarter of the floor.

However, despite these provisions, in many cases, each nurse isgenerally responsible for monitoring many patients at once. Further,many physiological parameters including heart rate, blood pressure, orthe like can be monitored for each patient. Thus, a nurse's job can bequite overwhelming and complex, especially when he or she is hearingmany audible noises at once, as it can be sometimes be difficult for thenurse to determine which audible noise corresponds to a particularpatient. Accordingly, techniques for enhancing patient monitoring aredescribed.

The localized sound projection systems 500A, 500B can implement soundlocalization techniques. Sound localization exploits a listener'sspatial-hearing “map,” a perceptual representation of where sounds arelocated relative to the head. Generally, listeners can hear a sound andcan identify the position of the sound or discriminate changes in thelocation of sounds. By coordinating or offsetting speakers, thelocalized sound projection systems 500A, 500B can simulate the placementof an auditory cue in a 3D space. In other words, the localized soundprojection systems 500A, 500B can, in essence, fool the listener's braininto thinking an audible noise originates from a particular location,such as a patient's room, a patient, a particular area in the nurses'station 504, etc.

The localized sound projection system 500A, 500B can adjust a location(sometimes referred to as origination location) at which a listenerthinks the audible noise originated in order to give the listenerimmediate insight as to a direction from which the issue arises. Forexample, if a patient indicator is activated for Patient A, localizedsound projection system 500A, 500B can cause an audible noise to soundas if it is coming from Patient A's room. Accordingly, the localizedsound projection system can advantageously aid a caregiver inidentifying the direction or location of a patient that necessitiesattention, which can speed up a caregiver response time.

A person's auditory system uses several cues for sound sourcelocalization, including time- and level-differences (orintensity-difference) between ears, spectral information, timinganalysis, correlation analysis, and pattern matching. Thus, system 500Acan include a plurality of speakers that are located at variouspositions in a space. For example, any of speakers 508, 510 can belocated on a hospital floor, a nursing station, or a patient's room. Thespeakers can be configured to simulate the placement of an auditorynoise, which may be an alarm or a sound, such as a heat beat, a chirp orany other noise meant to obtain the attention of the care provider in anintuitive way by altering one or more of a timing, intensity, frequency,etc. of a sound signal output by the speakers. For example, the timingcan be altered by a few milliseconds.

By altering a timing, intensity, frequency or one or more of thespeakers, the system 500A, 500B can simulate audible noises asoriginating from various locations, thereby making the listener believethe sounds are coming from the simulated location.

As a non-limiting example, each patient room 506 can include one or morepatient monitors that are configured to monitor physiological parametersof a patient. The system 500A can communicate with patient monitors in aplurality of patient rooms 506 (or can communicate with a centralizedsystem that communicates with the patient monitors). When a patientindicator is activated for a particular patient, the system 500A cancoordinate the audible noises of the speakers to make them sound as ifthey are originating from a particular location or direction, such as apatient, a patient's bed, a patient's room, or a general direction of apatient.

The system can utilize multiple speakers projecting audible noises atdifferent delays. For example, the system can utilize speakers, andbased on the activation of the patient indicator, the second speaker canproject an audible noise that is delayed by a few milliseconds relativeto an audible noise projected by another speaker. Accordingly, thesystem can fool a user's brain into thinking the audible noise is comingfrom a particular direction, such as a location of a patient's room or aspecific location on the patient. For example, the system can fool auser's brain into thinking that the audible noise is coming from thepatient's foot.

FIG. 5B illustrates a system 500B that includes a plurality of speakers520 and 522 that are configured to output audible noises. In some cases,the system 500B can include fewer or more speakers. For example, thesystem 500B can include 1, 3, 4, 5, 6, 7, 8 or more speakers.Furthermore, although the speakers are generally aligned around thepatient monitor 200, any one or more of the speakers 520, 522 can bealigned in any suitable manner throughout the patient room. Thus, theplacement of the speakers illustrated in FIG. 5B should not be construedas limiting.

The system 500A, 500B can utilize a speaker of one or more variousconnected devices to provide surround sound. For example, the system500A, 500B can be in communication with various devices (for example,patient monitors, televisions, etc.) that have an associated speaker.The system 500A, 500B, 500C can also utilize a sound calibration mode todetermine which of these connected devices have sound capabilities.Furthermore, the system 500A and 500B can determine a location of eachof the various devices and/or can determine from which direction orlocation the sounds will come from.

For example, the system 500A, 500B, 500C can transmit a command to oneor more of the connected devices and request that the device make asound. The patient monitoring system can then use a noise sensor tomonitor the sound and determine the direction, location, volume, etc. ofthe particular device. After acquiring this information for a pluralityof devices, the system 500B can then use the speakers of those devicesto provide localized projection of patient sounds. Because the variousconnected devices may by moved around the room, removed from the room,or added to the room, the patient monitoring system may periodicallyinitiate the sound calibration mode to reset the localized projection.

As described herein with respect to FIG. 5A, the system 500B can utilizeone or more of the speakers 520, 522 to output an audible noise tosimulate the audible noise as originating from various locations.

An abnormal parameter or system operating parameter can be associatedwith a specific portion of a patient's body. For instance, if the systemutilizes a pulse oximeter, then a probe off condition might beassociated with a patient's left or right hand. Similarly, a patient'srespiration rate might be associated with a patient's chest.Accordingly, in some cases, when the system wants to indicate an audiblenoise, it can utilize a speaker or speakers that is closest to theassociated portion of the patient's body or can project audible noisesusing a plurality of speakers in a particular direction. Using theexamples above, the system can utilize the speakers on the right side ofthe patient's body to indicate a probe off condition corresponding tothe patient's right hand. Similarly, the system can utilize the speakersnear the patient's head to indicate the activation of the patientindicator associated with the upper half of a patient's body. Forexample, the patient indicator associated with the upper half of thepatient's body can include an abnormal respiration rate. Accordingly,the system can utilize the speakers to indicate to the caregiver adirection and/or general location of the portion of the patient's bodywhich needs attention. Alternatively, a surround sound bar can be usedto project sound in a specific direction to draw the attention of careproviders in that direction.

The system can be utilized to localize the projection of an audiblenoise to make the audible noise sound as though it is coming from anailing body part or a portion of the patient's body that is associatedwith the activation of the patient indicator. By localizing the sound toa particular portion of the patient's body, a caregiver is quicklyinformed of the location on the patient which is experiencing an issueand the caregiver can more easily and more efficiently determine what iswrong with the patient. As a non-limiting example, if the patientmonitor detects that the patient is experiencing an abnormal heart rate,the surround sound can localize the sound of the audible noise to thepatient's heart, such that it sounds as though the audible noise iscoming from the patient's heart.

The audible noise or notification can be a sound that corresponds theactivation of the patient indicator. For instance, if a heart rateparameter is causing the activation of the patient indicator, then theaudible noise can sound like a beating heart. Thus, by hearing theaudible noise, and because a heartbeat is an easily identifiable noise,the caregiver will know that the heart rate is abnormal. Similarly, if apatient hydration parameter is causing an audible noise, the audiblenoise can sound like running or falling water. Different audible noisescan be set for each measured parameter, or a single audible noise can beset for any of a group of parameters. It should be noted however thatwhile any audible noise can be used to designate an alarm, it can beadvantageous for the audible noise to sound like or correspond to theabnormal parameter so as to help guide the caregiver. Alternatively orin addition, the audible noise can include an audible representation ofthe abnormal parameter. For instance, “oxygen saturation,”“carboxyhemoglobin,” “methemoglobin,” etc. can be spoken by the speakerwhen that particular parameter is abnormal.

FIG. 5C illustrates a system 500C that includes a patient monitor 200configured to adjust speaker parameters based on surrounding acoustics.The patient monitoring device 200 can include a plurality of speakers, anoise sensor, and an acoustics controller. Using the speakers, the noisesensor, and the acoustics controller, the patient monitor 200 cantransmit and detect a test auditory signal, and based on these signalscan determine an acoustics of the surroundings. The patient monitoringdevice can adjust one or more of the speaker parameters based on thedetermined acoustics.

The speakers of the patient monitoring device 200 can be integratedwithin a housing of the device. In some cases, the patient monitor 200includes two integrated speakers. However, in other cases, the system500C can include fewer or more speakers. For example, the system 500Bcan include 1, 3, 4, 5, 6, 7, 8 or more speakers. Each of the speakerscan have configurable settings which can be adjusted based offdetermined acoustics.

The noise sensor can include any of various types of sensors configuredto measure noise. For example, the noise sensor can include, but is notlimited to, a decibel reader, a microphone, or any other sensor capableof ambient noise detection.

The patient monitoring device 200 can include an acoustics controllerthat includes a processor. The processor of the acoustics controller canbe configured to control the speakers to output test auditory signals.Furthermore, the processor can receive noise data from the noise sensor.The noise data can correspond to the one or more tests signals. Based onthe test auditory signals output by the speakers and the noise datareceived from the noise sensor, the processor can determine an acousticsof a surrounding environment. For example, based on a change in the testsignal from when it was transmitted by the speakers two when it wasreceived by the noise sensor, the processor can determine one or moreproperties or qualities of the environment that determine how sound istransmitted in it. Based on these one or more properties or qualities ofthe environment, the system can adjust one or more speaker parameters ofthe speakers. In some cases, the adjustment can optimize speakers forthe determined acoustic environment.

FIG. 6 is a flow diagram illustrative of an embodiment of a routineimplemented by the system to provide localized projection of patientsounds via a plurality of speakers. One skilled in the relevant art willappreciate that the elements outlined for routine 600 can be implementedby a computing device such as sound localization controller incommunication with a plurality of speakers. In addition oralternatively, routine 600 can be implemented by the patient monitoringdevice 100 or another computing device in communication with orincorporating the plurality of speakers. Accordingly, routine 600 hasbeen logically associated as being generally performed by soundlocalization controller. However, the following illustrative embodimentshould not be construed as limiting. Furthermore, it will be understoodthat the various blocks described herein with reference to FIG. 6 can beimplemented in a variety of orders. For example, the patient monitoringdevice 100 can implement some blocks concurrently or change the order asdesired. Furthermore, it will be understood that fewer, more, ordifferent blocks can be used as part of the routine 600.

At block 602, the sound localization controller can receive anindication of an activation of the patient indicator. The indication ofthe activation of the patient indicator can include, but is not limitedto indications of waveforms, alerts, alarms or other data associatedwith physiological parameters of a patient monitoring device (forexample, device 100 or 150). As described herein, a patient monitoringdevice can be communicatively coupled to one or more physiologicalsensors. The patient monitoring device can receive one or more patientsignals from the physiological sensors and can determine measurements ofphysiological parameters of a patient from the received patient signals.The patient monitoring device can monitor patient indicators associatedwith the measurements of the physiological parameters. In some cases,the patient monitoring device can transmit the indication of theactivation of the patient indicator to the sound localizationcontroller. In addition or alternatively, the sound localizationcontroller can monitor the activation of the patient indicator.

The sound localization controller can be in communication with one ormore patient monitors that monitor one or more patients. For example, apatient monitor may be located in a patient's room, and the patientmonitor can be configured to monitor the patient residing in the patientroom. Other patient monitors can be located in the same room or in otherrooms and can monitor the same patient or other patients. The soundlocalization controller can communicate with one or more of the patientmonitors and can receive patient indicators from each of the patientmonitors with which it is in communication. In some cases, theindication of the activation of the patient indicator comprises otheridentifying information such as a physiological sensor identifier, apatient monitoring device identifier, a patient identifier, a patientroom identifier, or a speaker identifier. The sound localizationcontroller can also be part of one or more of the patient monitors.

In addition or alternatively, the sound localization controller can bein communication with a single device. For example, the soundlocalization controller can communicate with a centralized database thatincludes real-time patient information, such as real time physiologicalparameter data or real time alarm data.

At block 604, the sound localization controller can determine anorigination location of a patient indicator. As described in more detailherein, the localized sound projection system can implement soundlocalization techniques to exploit a listener's spatial-hearing “map.”By coordinating or offsetting speakers, the sound localizationcontroller can simulate the placement of an auditory cue in a threedimensional (3D) space. In other words, the sound localizationcontroller can fool a listener's brain into thinking a sound originatesfrom a particular location. The sound localization controller determinesthe desired location at which the controller will cause the sound tooriginate.

The origination location can be a particular location. For example, theorigination location can include a general or specific location of aphysiological sensor, a patient monitoring device, a patient, apatient's room, a speaker, etc.

In some cases, the origination location can correspond to an ailing bodypart or a portion of the patient's body that is associated with thepatient indicator. As a non-limiting example, if the activation of thepatient indicator corresponds to a patient's heartbeat, the originationlocation can be the location of the patient's chest. Accordingly, theaudible noise can sound as though it is coming from the direction ofpatient's heart. By localizing the sound to a particular portion of thepatient's body, a caregiver is quickly informed of the location on thepatient which is experiencing an issue and the caregiver can more easilyand more efficiently determine what is wrong with the patient.

Furthermore, in some cases, the audible noise can correspond to thephysiological parameter associated with the activation of the patientindicator. For example, if the activation of the patient indicatorcorresponds to a patient's heartbeat, the audible noise can sound like abeating heart. In some cases, the sound will be the patient's heartbeat,rather than an arbitrary heartbeat.

The sound localization controller can determine the target originationlocation using various techniques. For example, in some cases, the soundlocalization controller can access a database (for example, a lookuptable) which correlates the activations of the patient indicators withorigination locations. In addition or alternatively, the soundlocalization controller can receive the origination location from apatient monitor, such as along with the indication the patientindicator.

The target origination location can correspond to a location of aspeaker. For example, the target origination location can correspond tothe location of the speaker that is closest to the source of the patientindicator (for example, the patient, the sensor, the patient's room, thephysiological monitor, etc.). Accordingly, the sound localizationcontroller can determine a location of one or more of the plurality ofspeakers and can also determine a location of the source of the patientindicator. The sound localization controller can then select as theorigination location the location of the speaker closest to the sourceof the patient indicator.

At block 606, based at least in part on the origination location and/ora location of one or more of the speakers, the sound localizationcontroller can identify one or more sound parameters. As describedherein, each of the speakers can be configured to output auditorysignals. In some cases, each of the speakers output an identical audiblenoise, save one or more sound parameters. The sound parameters caninclude, but are not limited to, a timing, intensity, or frequency ofthe audible noise.

In other words, at block 606, the sound localization controllerdetermines how to adjust or modify the sound signals output by thespeaker to provide the desired localized projection. In some cases, thesound parameters are based at least in part on the origination locationand/or the location of one or more speakers. For example, first speakersthat are further from the origination location than second speakers canhave sound parameters that include a time delay (for example, 1, 2, 3,4, 5, 10, milliseconds (+/−a few milliseconds)). Accordingly, sound fromfirst speakers can be time-delayed from the sound of the secondspeakers).

At block 608, the sound localization controller determines the signalswhich it will cause the speakers to output. For example, as describedhere, each of the speakers may be configured to output an identicalaudible noise, save the one or more sound parameters determined at block606.

At block 610, the sound localization controller controls the speakers tooutput the plurality of audible noises that have been adjusted based onthe sound parameters.

FIG. 7 is a flow diagram illustrative of an embodiment of a routineimplemented by a system to adjust speaker settings based on surroundingacoustics. One skilled in the relevant art will appreciate that theelements outlined for routine 700 can be implemented by an acousticcontroller in communication with a plurality of speakers and a noisesensor. In addition or alternatively, routine 700 can be implemented bythe patient monitoring device 200 or another computing device incommunication with or incorporating the plurality of speakers.Accordingly, routine 700 has been logically associated as beinggenerally performed by patient monitoring device 200. However, thefollowing illustrative embodiment should not be construed as limiting.Furthermore, it will be understood that the various blocks describedherein with reference to FIG. 7 can be implemented in a variety oforders. For example, the patient monitoring device 200 can implementsome blocks concurrently or change the order as desired. Furthermore, itwill be understood that fewer, more, or different blocks can be used aspart of the routine 700.

At block 702, the patient monitoring system controls a plurality ofspeakers to output one or more tests auditory signals. The speakers canbe integrated within a housing of the patient monitoring device 200. Insome cases, the patient monitor 200 includes two integrated speakers.However, in other cases, the system can include fewer or more speakers.For example, the system can include 1, 3, 4, 5, 6, 7, 8 or morespeakers. Each of the speakers can have configurable settings which canbe adjusted based off determined acoustics.

At block 704, the patient monitoring system receives noise datacorresponding to the test auditory signals. For example, the patientmonitoring system can include a noise sensor. The noise sensor caninclude any of various types of sensors configured to measure noise. Forexample, the noise sensor can include, but is not limited to, a decibelreader, a microphone, or any other sensor capable of ambient noisedetection. The noise sensor can sense the test signals after they aretransmitted by the speakers into the environment, and can provide noisesensor data to the patient monitor.

At block 706, the patient monitor can determine acoustics of thesurrounding environment based at least on the received noise data fromthe noise sensor. For example, based on a change in the auditory testsignal transmitted by the speakers to the signal received by the noisesensor, the processor can determine one or more properties or qualitiesof the environment that determine how sound is transmitted in it.

At block 708, based on these properties or qualities of the environmentthat correspond to the acoustics, the patient monitor can adjust ormonitor one or more speaker parameters of the speaker. In some cases,the adjustment can optimize speakers for the determined acousticenvironment.

Adjust Volume

Reducing hospital noise and creating a quieter environment for patientscan increase both patient satisfaction and patient outcomes. Somehospitals have implemented quiet zones (sometimes known as quiet rooms)where patients and their families can go to relax, on what may be someof the most difficult days of their lives. Similarly, regardless ofwhether a quiet area exists, certain times of the day, such asnighttime, are preferably quieter. For example, patients may be tryingto sleep at this time. Though noise is not responsible for all sleepdisruptions, its contribution is significant. In addition, researchershave found the sick and the elderly are the most likely to have theirsleep disturbed by noise, and people never completely habituatethemselves to nighttime noise. In contrast, many times throughout ahospital day can be hectic and loud. Thus, during these times, quietaudible noises might not be attended to or even heard.

Accordingly, it is an object of the present disclosure to provide aphysiological monitoring system that adjusts a speaker volume responsiveto changes in environmental noise and/or changes in the time of day. Forexample, based on an ambient noise level or a time of day, thephysiological monitoring system can determine that a quieter audiblenoise is preferred and can lower a volume of a speaker. In contrast,based on an ambient noise level or a time of day, the physiologicalmonitoring system can determine that a louder audible noise is preferredand can raise a volume of a speaker.

FIG. 8 is a flow diagram illustrative of an example of a routine foradjusting volume of a speaker. It will be understood that the variousblocks described herein with reference to FIG. 8 can be implemented in avariety of orders. For example, the patient monitoring system canimplement some blocks concurrently or change the order, as desired.Furthermore, it will be understood that fewer, more, or different blockscan be used as part of the routine 800.

At block 802, a patient monitoring system can determine a volume of aspeaker. The speaker can be an internal speaker similar to the speakerillustrated in FIG. 3, or an external speaker similar to the speaker 400illustrated in FIG. 4. In some cases, the volume level of the speaker isa parameter known by the patient monitoring system, while in other casesthe patient monitoring system can measure the volume of the speakerusing a decibel reader, a microphone, or any other sensor capable ofnoise detection.

At block 804, the patient monitoring system monitors and determines alevel of ambient noise. For example, the system can utilize an ambientnoise sensor such as a decibel reader, a microphone, or any other sensorcapable of ambient noise detection. Ambient noise can include, but isnot limited to, noise in the surrounding environment (such as within acertain distance from the patient monitor), noise in the patient's room,noise on the corresponding hospital floor, noise outside the hospital,etc.

The determination of the level of ambient noise can include adetermination of an ambient noise decibel level. For example, if thespeaker is providing an audible noise while the patient monitor ismonitoring the ambient noise, the detected level of ambient noise may behigher than the actual ambient noise. Accordingly, the ambient noisesensor can compensate for the sound of the speaker such that the patientmonitor can determine an accurate level of ambient noise.

The patient monitoring system can continuously or periodically monitorthe level of ambient noise. For instance, the ambient noise level can bemonitored every 30 seconds, 1 minutes, 5 minutes, 30 minutes, 1 hour,etc.

At block 806, the patient monitoring system can determine a thresholdvolume. In some cases, the threshold volume may be based at least inpart on the ambient noise level measured at block 804. For example, thethreshold volume can be matched to the ambient noise level. Accordingly,based at least in part on a determination that the ambient noise levelcorresponds to a quiet zone, the patient monitoring system can determinethat the threshold volume corresponds to the volume of the quiet zone.Similarly, based at least in part on a determination that the ambientnoise level corresponds to a louder area, the patient monitoring systemcan determine that the threshold volume corresponds to the loudervolume.

In addition or alternatively, the patient monitoring system candetermine the threshold volume based at least in part on the time ofday. For example, the patient monitoring system can determine the timeof day and can determine the threshold volume based at least in part onthe time of day. For example, a correlation between the time of day andthe threshold volume can be in a database that the patient monitoringsystem can access. As a non-limiting example, the patient monitoringsystem can determine that the time of day corresponds to nighttime.Accordingly, the patient monitoring system can determine that thethreshold volume corresponds to a quiet zone. In contrast, the patientmonitoring system can determine that the time of day corresponds todaytime. Accordingly, the patient monitoring system can determine thatthe threshold volume corresponds to a normal or average volume.

Continuing with block 806, the patient monitoring system can determinewhether the volume of the speaker satisfies the threshold volume. Insome cases, the volume of the speaker does not satisfy the thresholdvolume unless the volume of the speaker matches the threshold volume.Accordingly, if the volume of the speaker does not match the thresholdvolume than the process continues to block 708, where it can adjust thevolume of the speaker. However, and other cases, the volume of thespeaker satisfies the threshold volume if the volume of the speaker iswithin a distance threshold of the threshold volume. The distancethreshold can vary across embodiments. For example, the distancethreshold can correspond to a particular difference in decibel levelbetween the threshold volume. For example, the distance threshold cancorrespond to 1 dB, 2 dB, 5 dB, 10 dB, 20 db, or 25 dB.

If the processor determines that the volume of the speaker satisfies thevolume threshold, or is within a distance threshold of the volumethreshold, then the volume of the speaker is not adjusted. The processorcan return to block 804 to continue monitoring the ambient noise level.

At block 808, the processor determines that the volume of the speakerdoes not satisfy the volume threshold. In other words, the processordetermines that the volume of the speaker is not within a distancethreshold of the volume threshold. Accordingly, the processor adjuststhe volume of the speaker. For example, if the volume of the speaker isabove the volume threshold then the volume of the speaker can bereduced. In some cases, the volume of the speaker is reduced by apredetermined amount, for instance, 5, 10, 15, 20, or 25 dB. Reducingthe volume of the speaker by a predetermined amount can be advantageousbecause the threshold volume can sometimes be drastically different fromthe volume of the speaker. Accordingly, it may be preferred to graduallychange the speaker volume rather than change is dramatically.Alternatively, the processor can adjust the volume of the speaker tomatch the threshold volume. Similarly, the processor can adjust thevolume of the speaker to fit within the distance threshold of thethreshold volume.

As another example, if the volume of the speaker is below the volumethreshold then the volume of the speaker can be increased. In somecases, the volume of the speaker is increased by a predetermined amount,for instance, 5, 10, 15, 20, or 25 dB. Increasing the volume of thespeaker by a predetermined amount can be advantageous because thethreshold volume can sometimes be drastically different from the volumeof the speaker. Accordingly, it may be preferred to gradually change thespeaker volume rather than change is dramatically. Alternatively, theprocessor can adjust the volume of the speaker to match the thresholdvolume. Similarly, the processor can adjust the volume of the speaker tofit within the distance threshold of the threshold volume.

As a non-limiting example, if the ambient noise sensor detects anambient noise level indicative of a quiet zone, the physiologicalmonitoring system can reduce the volume of the speaker if the speaker isabove 60 dB. For instance, if the speaker is above 60 dB, the volume canbe gradually reduced by a few dB until the actual speaker volumesatisfies the volume threshold.

The physiological monitoring system can turn off (or mute) some or allaudible noises in response to determining that quiet zone exists (forexample, based on detected environmental noise, time of day, etc.). Forexample, the physiological monitoring system can mute alarms which arenot critical to patient health or those that do not require immediateaction. In some cases, the patient monitoring system alters the volumeof non-critical parameters, but does not alter the volume of criticalparameters. Alternatively or in addition, in response to determiningthat quiet is preferred the physiological monitoring system can cause anew visual patient indicator to display or can cause a visual indicatorto display more brightly or noticeably. Similarly, in response to adetermination that a quiet zone does not exist, some or all audiblenoises can be turned on or unmuted. For example, even alarms which arenot critical to patient health or do not require immediate action may beactivated or turned on.

As another non-limiting example, based on a determination that a time ofday or ambient noise level indicates a quiet zone, the physiologicalmonitoring system can reduce the volume of the speaker to conform withthe requirements of the quiet zone. However, if a sudden commotionoccurs that increases the ambient noise, the system can re-asses thevolume of the speaker. For example, a crashing patient in need ofassistance can significantly increase the ambient noise levels.Accordingly, based on a determination that the ambient noise level hasincreased, the system can increase the volume of the speaker to ensurethe speaker's audible signals can be heard. When the emergency subsidesand the quiet zone quietens again, the system can determine the ambientnoise levels indicate a quiet zone, and can reduce the volume of thespeaker.

Adjust Display Settings

In some instances, a display associated with a patient monitor or othermedical device can be difficult to see or cause eyestrain because theambient light surrounding the display is too intense. Accordingly, itcan be advantageous to adjust the display settings of the display inresponse to the surround ambient light. For example, the human eyeperceives different colors under different levels of illumination(sometimes referred to as the Purkinje effect). Accordingly, thephysiological monitoring system can adjust the tint of the display toassist a user in perceiving the correct color. As such, it is an objectof the present disclosure to adjust a display based on the ambientlight, by dimming the display to lessen eyestrain, diminish annoyingbright lights, and/or provide better picture quality. In addition oralternatively, it is an object of the present disclosure to adjust adisplay based on the ambient light by brightening the disclosure toincrease visibility.

FIG. 9 is a flow diagram illustrative of an example of a routine foradjusting display settings of a display. It will be understood that thevarious blocks described herein with reference to FIG. 9 can beimplemented in a variety of orders. For example, the patient monitoringsystem can implement some blocks concurrently or change the order, asdesired. Furthermore, it will be understood that fewer, more, ordifferent blocks can be used as part of the routine 900.

At block 902, a patient monitoring system can determine display settingsof a display. For instance, the display settings can include, but arenot limited to, brightness, tint, contrast, color, color saturation,color temperature, sharpness, and/or backlight. Brightness can indicatehow dark the dark areas of the image are, and backlight can indicate howbright the image is. In some cases, the display settings are parametersknown by the patient monitoring system.

At block 904, the patient monitoring system can monitor and determine anintensity of ambient light. For example, the patient monitor can utilizean ambient light sensor to determine the intensity of ambient light. Insome cases, the intensity of ambient light can include the intensity oflight in the surrounding environment. The patient monitoring system cancontinuously or periodically monitor the intensity of ambient light. Forinstance, the ambient light can be monitored every 30 seconds, 1minutes, 5 minutes, 30 minutes, 1 hour, etc.

At block 906, the patient monitoring system can determine a displaythreshold. In some cases, the display threshold may be based at least inpart on the ambient light level measured at block 904. For example, thedisplay threshold can be matched to the ambient light level.Accordingly, based at least in part on a determination that the ambientlight level corresponds to a dark environment, the patient monitoringsystem can determine that the display threshold corresponds to the adark environment. For a bright environment, it may be advantageous tohave a dull or less bright display. Similarly, based at least in part ona determination that the ambient light level corresponds to a brightenvironment, the patient monitoring system can determine that thethreshold volume corresponds to a bright environment. For a brightenvironment, it may be advantageous to have a bright display.

In addition or alternatively, the patient monitoring system candetermine the display threshold based at least in part on the time ofday. For example, the patient monitoring system can determine the timeof day and can determine the display threshold based at least in part onthe time of day. For example, a correlation between the time of day andthe threshold volume can be in a database that the patient monitoringsystem can access. As a non-limiting example, the patient monitoringsystem can determine that the time of day corresponds to nighttime.Accordingly, the patient monitoring system can determine that thethreshold volume corresponds to a dark environment. In contrast, thepatient monitoring system can determine that the time of day correspondsto daytime. Accordingly, the patient monitoring system can determinethat the display threshold corresponds to a bright environment.

Continuing with block 906, the patient monitoring system can determinewhether the display settings satisfy the display threshold. In somecases, the display settings of the display do not satisfy the displaythreshold unless the display settings of the display match the displaythreshold. Accordingly, if the display settings of the display do notmatch the display threshold, then the process can continue to block 908,where it can adjust the display settings of the display. However, inother cases, the display settings of the display satisfy the displaythreshold if the display settings of the threshold or within a distancethreshold of the display threshold. The distance threshold can varyacross embodiments. For example, distance threshold can include 1, 2, 5,10, 20, or 25 arbitrary display units.

At block 908, the processor determines that the display parameters ofthe display do not satisfy the display threshold. In other words, theprocessor determines that the volume of the speaker is not within adistance threshold of the volume threshold. Accordingly, the processoradjusts the display parameters of the display for example, bybrightening the display or reducing a brightness of the display.

As a non-limiting example, if the ambient light sensor detects a lowlevel of light (for example, a dim room) and detects the display is setat a high tint level, the physiological monitoring system can determinea tint of the display does not satisfy a tint threshold. Accordingly,the processor can adjust the display by increasing or decreasing thetint. Similarly, the physiological monitoring system can adjust thedisplay settings of a display in response to the ambient light sensordetecting a high level of light (for example, a bright room). Forinstance, if the ambient light sensor detects a high level of light anda dull display, the physiological monitoring system can adjust thedisplay by increasing the brightness, increasing the contrast, and/ortinting the screen color.

In addition or alternatively, the physiological monitoring system canadjust the display settings of the display based on the time of day. Forinstance, the display can be set to a high brightness mode during theday and a low brightness mode later into the evening. The display cancycle between these modes automatically or can be cycled manually by auser.

Voice Control

FIG. 10 is a flow diagram illustrative of an example of a routine 1000for audibly altering parameters of a medical device. It will beunderstood that the various blocks described herein with reference toFIG. 10 can be implemented in a variety of orders. For example, thepatient monitoring system can implement some blocks concurrently orchange the order, as desired. Furthermore, it will be understood thatfewer, more, or different blocks can be used as part of the routine1000.

At block 1002, the medical device listens for an activation phrase. Forexample, the device can utilize a speaker/microphone combination whichis constantly listening for the activation phrases (sometimes referredto as a wake-up phase or wake-up word). In some cases, the activationphrase can be, for example, “Hey Patient Monitor.”

At block 1004, the device determines that an activation phrase has beenrecited. The system can acknowledge that it has heard the activationphrases. For example, it may give a verbal acknowledgement or a visualindicator.

At block 1006, the device listens for an oral command. The system caninclude a database of oral commands of which it can be requested. Forinstance, a user may be able to change a parameter, an alarm setting, amedical level, or otherwise manipulate a medical device through voicecontrol. In some cases, the system can understand oral commands even ifthey do not exactly match what is in the database of command.Accordingly, many commands work when worded several different ways oreven with words omitted.

At block 1008, the device determines whether it received an oral commandwithin a specified time period. In some cases, a user may “wake-up” themedical device accidentally or may forget how they want to manipulatethe device. Accordingly, if a specified time period expires without thedevice receiving an oral command, the device advantageously returns to asleep state and listens for another activation phrase (step 1002). Thetime period can be, for example, about 1, 2, 3, 4, or 5 seconds.

At block 1010, the device determines that it did receive an oralcommand, or at the least, the device heard some audible noise.Accordingly, the device determines whether it recognized command, forinstance, by comparing the command to a library of commands. Asmentioned above, many commands may be accepted, despite being wordeddifferently or even leaving out words.

At block 1012, the device determines that it did not recognize thecommand and it requests a user to repeat the command. Then it returns toblock 1006 to listen for another oral command. In some cases, if thedevice does not recognize the command, it will predict or suggest acommand based on the received oral command. In addition oralternatively, the device can revert back to block 1002, where it willlisten for an activation phrase.

At block 1014, the device determined that it did recognize the oralcommand. The device then acknowledges the command and requests aconfirmation that the acknowledged command is accurate.

The device can acknowledge the command by repeating it aloud via aspeaker. In addition or alternatively, the device can acknowledge thecommand by displaying the command on a display. In addition oralternatively, the device may not acknowledge the command.

The device then requests a confirmation from the user of theacknowledged command. For instance, the device can ask the user aquestion and the user can respond affirmatively. For instance, thedevice may ask the user, “Change pressure settings to 20 PSI?” If theuser agrees, the user can respond verbally (for example, “Yes”) orrespond by selecting an input of the device. The confirmation requestcan be presented on a display for someone to accept. This advantageouslyallows the user to read exactly what command the device will performrespond accordingly.

At block 1016, the device determines whether it received a confirmationwithin a specified period of time. If it does not (or if the userresponds negatively to the confirmation request) then the device can askthe user to repeat the command (block 1012), listen for activationphrase (block 1002) or send another request for confirmation (block1014). The time period can be, for example, about 1, 2, 3, 4, or 5seconds.

At block 1018, the device has determined which command the user desiresit to perform and has received a confirmation from the user of thatcommand. Accordingly, the device performs the action associated with thecommand.

Terminology

The term “and/or” herein has its broadest least limiting meaning whichis the disclosure includes A alone, B alone, both A and B together, or Aor B alternatively, but does not require both A and B or require one ofA or one of B. As used herein, the phrase “at least one of” A, B, “and”C should be construed to mean a logical A or B or C, using anon-exclusive logical or.

The term “plethysmograph” includes it ordinary broad meaning known inthe art which includes data responsive to changes in volume within anorgan or whole body (usually resulting from fluctuations in the amountof blood or air it contains).

The following description is merely illustrative in nature and is in noway intended to limit the disclosure, its application, or uses. Forpurposes of clarity, the same reference numbers will be used in thedrawings to identify similar elements. It should be understood thatsteps within a method may be executed in different order withoutaltering the principles of the present disclosure.

As used herein, the term module may refer to, be part of, or include anApplication Specific Integrated Circuit (ASIC); an electronic circuit; acombinational logic circuit; a field programmable gate array (FPGA); aprocessor (shared, dedicated, or group) that executes code; othersuitable components that provide the described functionality; or acombination of some or all of the above, such as in a system-on-chip.The term module may include memory (shared, dedicated, or group) thatstores code executed by the processor.

The term code, as used above, may include software, firmware, and/ormicrocode, and may refer to programs, routines, functions, classes,and/or objects. The term shared, as used above, means that some or allcode from multiple modules may be executed using a single (shared)processor. In addition, some or all code from multiple modules may bestored by a single (shared) memory. The term group, as used above, meansthat some or all code from a single module may be executed using a groupof processors. In addition, some or all code from a single module may bestored using a group of memories.

The apparatuses and methods described herein may be implemented by oneor more computer programs executed by one or more processors. Thecomputer programs include processor-executable instructions that arestored on a non-transitory tangible computer readable medium. Thecomputer programs may also include stored data. Non-limiting examples ofthe non-transitory tangible computer readable medium are nonvolatilememory, magnetic storage, and optical storage. Although the foregoinginvention has been described in terms of certain preferred embodiments,other embodiments will be apparent to those of ordinary skill in the artfrom the disclosure herein. Additionally, other combinations, omissions,substitutions and modifications will be apparent to the skilled artisanin view of the disclosure herein. Accordingly, the present invention isnot intended to be limited by the reaction of the preferred embodiments,but is to be defined by reference to claims.

Additionally, all publications, patents, and patent applicationsmentioned in this specification are herein incorporated by reference tothe same extent as if each individual publication, patent, or patentapplication was specifically and individually indicated to beincorporated by reference.

What is claimed is:
 1. A method for producing a sound in a medicalsetting, the sound giving the impression as if it is coming from aparticular direction, the method comprising: receiving a notificationregarding a status of a patient; and based at least in part on thestatus of the patient, controlling a plurality of speakers to produce asound that appears as if the sound is coming from a particulardirection, wherein said controlling comprises: determining anorigination location, and for each of the plurality of speakers:determining at least one sound parameter based at least in part on theorigination location, the at least one sound parameter comprising atleast one of a timing, an intensity, or a frequency, and causing theparticular speaker to produce a noise associated with the at least onesound parameter, wherein the sound comprises the plurality of noisesfrom the plurality of speakers, and wherein the sound gives theimpression as if it is coming from a direction associated with theorigination location.
 2. The method of claim 1, wherein the originationlocation comprises a location of a patient monitor.
 3. The method ofclaim 2, wherein the patient monitor comprises a physical patientmonitor.
 4. The method of claim 1, wherein the origination locationcorresponds to a location associated with the patient.
 5. The method ofclaim 4, wherein the origination location comprises a location of atleast one of a chest, a head, or a foot of the patient.
 6. The method ofclaim 1, wherein the origination location comprises a location of atleast one of a physiological sensor or a patient room.
 7. The method ofclaim 1, wherein the sound simulates the placement of an auditory cue inthe origination location.
 8. The method of claim 1, wherein theplurality of speakers comprises a first speaker and a second speaker,wherein the noise produced by the first speaker comprises an alarmsignal, wherein the noise produced by the second speaker comprisestime-delayed copy of the alarm signal produced by the first speaker. 9.The method of claim 1, wherein the origination location is differentfrom a location of each speaker of the plurality of speakers.
 10. Themethod of claim 1, wherein the notification comprises a patient signal,wherein the method further comprises determining at least onephysiological measurement based at least in part on the patient signal.11. The method of claim 1, wherein said determining the at least onesound parameter comprises accessing a data store and selecting, from thedata store, a first sound parameter that is associated with theorigination location.
 12. A system for producing a sound in a medicalsetting, the sound giving the impression as if it is coming from aparticular direction, the system comprising: a sound localizationcontroller in communication with a plurality of speakers and configuredto: receive a notification regarding a status of a patient; and based atleast in part on the status of the patient, control the plurality ofspeakers to produce a sound that gives the impression as if it is comingfrom a direction associated with an origination location, wherein tocontrol the plurality of speakers the sound localization controller isconfigured to: determine the origination location, and for each of theplurality of speakers: determine at least one sound parameter based atleast in part on the origination location, the at least one soundparameter comprising at least one of a timing, an intensity, or afrequency, and cause the particular speaker to produce a noiseassociated with the at least one sound parameter, wherein the soundcomprises the plurality of noises from the plurality of speakers. 13.The system of claim 12, wherein the origination location comprises alocation of a patient monitor.
 14. The system of claim 12, wherein thepatient monitor comprises a physical patient monitor.
 15. The system ofclaim 12, wherein the origination location comprises a location of atleast one of a chest of the patient, a head of the patient, or a foot ofthe patient.
 16. The system of claim 12, wherein the originationlocation comprises a location of at least one of a physiological sensoror a patient room.
 17. The system of claim 12, wherein the soundsimulates the placement of an auditory cue in the origination location.18. The system of claim 12, wherein the plurality of speakers comprisesa first speaker and a second speaker, wherein the noise produced by thefirst speaker comprises an alarm signal, wherein the noise produced bythe second speaker comprises time-delayed copy of the alarm signalproduced by the first speaker.
 19. The system of claim 12, wherein thenotification comprises a patient signal, wherein the sound localizationcontroller is further configured to determine at least one physiologicalmeasurement based at least in part on the patient signal.
 20. The systemof claim 12, wherein to determine the at least one sound parameter, thesound localization controller is configured to access a data store andselect, from the data store, a first sound parameter that is associatedwith the origination location.